Akathisia Leading into Panic Attacks

[phenethylamine]

Hi,

I am new to the boards and have recently been diagnosed with BP1 and anxiety. I am in kind of a bizarre mixed state right now as I try to adjust to my new meds. I am on 25 mg pd Lamictal, 1 mg Klonopin twice a day, and Seroquel at night. Every afternoon, before I have taken my second dose of Klonopin, I start to get extremely agitated and irritable, and cannot stop moving at all. It is definitely akathisia. Sometimes this accelerates into a panic attack, but sometimes I am able to settle myself down/take my second dose of Klonopin early enough to catch it. Here is my question: is this a possible side effect of any of these drugs or is it just me going manic again? (A couple weeks ago when I thought I just had anxiety and depression I took Celexa and it sent me into an EXTREME manic/borderline psychotic state...panic attack, hallucination, incoherent talking, the whole deal...and especially this extreme akathisia.) The restlessness and irritability is so uncomfortable and is driving my family nuts...is it a side effect or is it just me? If this another clue, once I am properly Klonopin-ed up after one of these states, I am relaxed and not restless but I am soooooo hopelessly depressed. I just feel worthless. I hope this is taken care of once my Lamictal is titrated up to a decent dose, but who knows....anyway.

Thanks for reading.

[mrsloony]

Its good that the klonopin helps some and that you are learning to catch it. You may want to ask pdoc if another dose a day would keep it in check.

That said- the thing is mania, akathesia and panic have so many overlapping syptoms it can be hard to know whats what ( and unfortunately all 3 can overlap too)

Definately time to call pdoc who may have ideas for you of any changes additions etc.

( I got horrible akathesia from a med that then turned into a drug induced mania. these meds can be really helpful but there are a lot of bumps along the way.

Good luck, mrsl

[crazynotstupid]

It may be akathesia; it may not. Seroquel would be the likely cause of that, but without knowing the dose, i couldn't say how likely.

However. Lamictal, even at such a low dose, can cause similar sensations. Anxiety/agitation are known effects at startup and dose changes. A suggestion: maybe either change the time of the dose, or split it ( a pain I know, with those tiny pills, but maybe worth a shot).

Absolutely call your pdoc. Feeling like shit, I say, deal. Feeling like total shit, all the time? Something needs to change.

[bxt227us]

so, how much seroquel? That's the only one that should be able to induce true akathisia. There's a big difference between restlessness and true freezing/involuntary movements. I guess if you're below 100mg seroquel then it's probably restlessness. They push seroquel as an antidepressant...maybe you need to be on an antidepressant (higher dose of seroquel or something else) Also, titrating lamictal can make you many flavors of nuts (but worth it in my opinion...ride it out). Well, maybe that's not much help; adjusting to new meds blows. Lamictal made an enormous positive change in my life and you might have to get a little sick to see what it can do. Ditto for seroquel. All SSRIs make me violently ill: bright colors, memory loss, nausea, too much mind noise to even be paranoid...Keep us posted how you are doing and try to stick with meds for 6 weeks before bailing on them. Neuroscience undergrad? I'm a tech in that field but don't have to deal with the stress of school, just do bad things to mice!

good luck

[usernametaken]

hey

hazarding a non-medical professional guess, i'd say the Lamictal is too activating at that low dose and the restless/iritability is a manic type energy hitting the wall of frustration about life right now. talk to your pdoc first and then figure times in your day to work on something with the manic energy-cleaning, excersizing, GRE studying- its really hard sometimes to move yourself out of a state to do those things, but once they are in motion, it makes all the difference. a work-out really helps with sleep too which helps the mania calm.

[phenethylamine]

Thanks guys,

I think you are right about it not being akisthisia, I am getting all kinds of weird manic business as I titrate up the Lamictal. I hope it all evens out soon, thanks for the help!

[GaryRN]

Hi,

I am new to the boards and have recently been diagnosed with BP1 and anxiety. I am in kind of a bizarre mixed state right now as I try to adjust to my new meds. I am on 25 mg pd Lamictal, 1 mg Klonopin twice a day, and Seroquel at night. Every afternoon, before I have taken my second dose of Klonopin, I start to get extremely agitated and irritable, and cannot stop moving at all. It is definitely akathisia. Sometimes this accelerates into a panic attack, but sometimes I am able to settle myself down/take my second dose of Klonopin early enough to catch it. Here is my question: is this a possible side effect of any of these drugs or is it just me going manic again? (A couple weeks ago when I thought I just had anxiety and depression I took Celexa and it sent me into an EXTREME manic/borderline psychotic state...panic attack, hallucination, incoherent talking, the whole deal...and especially this extreme akathisia.) The restlessness and irritability is so uncomfortable and is driving my family nuts...is it a side effect or is it just me? If this another clue, once I am properly Klonopin-ed up after one of these states, I am relaxed and not restless but I am soooooo hopelessly depressed. I just feel worthless. I hope this is taken care of once my Lamictal is titrated up to a decent dose, but who knows....anyway.

Thanks for reading.

I'm on day #6 at 25mg and am getting the same exact thing as you describe above. Like you, I also take Klonopin. I can't think of any other cause. Gary

Hi,

I am new to the boards and have recently been diagnosed with BP1 and anxiety. I am in kind of a bizarre mixed state right now as I try to adjust to my new meds. I am on 25 mg pd Lamictal, 1 mg Klonopin twice a day, and Seroquel at night. Every afternoon, before I have taken my second dose of Klonopin, I start to get extremely agitated and irritable, and cannot stop moving at all. It is definitely akathisia. Sometimes this accelerates into a panic attack, but sometimes I am able to settle myself down/take my second dose of Klonopin early enough to catch it. Here is my question: is this a possible side effect of any of these drugs or is it just me going manic again? (A couple weeks ago when I thought I just had anxiety and depression I took Celexa and it sent me into an EXTREME manic/borderline psychotic state...panic attack, hallucination, incoherent talking, the whole deal...and especially this extreme akathisia.) The restlessness and irritability is so uncomfortable and is driving my family nuts...is it a side effect or is it just me? If this another clue, once I am properly Klonopin-ed up after one of these states, I am relaxed and not restless but I am soooooo hopelessly depressed. I just feel worthless. I hope this is taken care of once my Lamictal is titrated up to a decent dose, but who knows....anyway.

Thanks for reading.

I'm on day #6 at 25mg and am getting the same exact thing as you describe above. Like you, I also take Klonopin. I can't think of any other cause. Gary